Plan Review Application Form

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1 Plan Review Application Form Application date: Date of ARC Meeting: Type of Review: (circle one) Concept Plan / Schematic Plan / Design Plan / Construction Plan / Modification / Miscellaneous 1. Application will be accepted after all information is provided. Please note that a complete application will streamline the approval process by decreasing the number of conditions of approval that the ARC may stipulate. 2. Fee must be submitted at the time of application. Please note that there is a fee required for all Reviews. 3. A Letter of Authorization signed by Owner must be submitted with the Concept Application. 4. A copy of the County Building Permit approval letter needs to be submitted prior to the start of construction. 5. A construction schedule is required to be submitted to the ARC prior to the start of construction, and will be used for the purpose of inspections. This schedule should be updated quarterly. 6. The Owners of any homes with a designated View Corridor as noted on the ARC map dated Feb 2006 will be required to sign a letter acknowledging the View Corridor and will be responsible for all maintenance of landscaping necessary to abide by the View Corridor. 7. Please contact GTPM staff regarding application questions. Section I Project information A. NAME OF PROJECT: Project Description: B. LOCATION OF PROJECT: Legal Description: Lot Other Street Address: C. NAME OF APPLICANT: Firm: Mailing Address: Telephone: ( ) Fax: 1 of 10 pages

2 Section I Project information - Continued. D. NAME OF OWNER(S): Mailing Address: Telephone: ( ) Fax: E. NAME OF ARCHITECT CONTRACTED WITH: Mailing Address: Telephone: ( ) Fax: F. Name of Landscape Architect contracted with: Mailing Address: Telephone: ( ) Fax: G. Name of Contractor: Mailing Address: Telephone: ( ) Fax: I have read and will comply with the 3 Creek Ranch Construction Activities and Compliance Deposit Regulation concerning construction activities and compliance deposit regulations of 3 Creek Ranch. Signature Date Printed Name 2 of 10 pages

3 Section II, Submittal Requirement Procedures Summary Name of Project: Location: Lot 1. Estate and Ranch lots are required to apply for Concept, Schematic Design and Construction Reviews with the ARC for all projects within the 3 Creek Ranch. Cabin lots may combine the Concept and Schematic reviews and then proceed with the Design and Construction Reviews. 2. Fees should be submitted with all applications. Fees are based on schedule provided by the HOA. Checks should be made payable to the 3 Creek Ranch Architectural Review Committee. A. CONCEPT PLAN REVIEW 1. The intent of the Concept Review is to allow the Applicant and Owner the ability to ask questions, review Design Guidelines and discuss site restrictions of the proposed project. 2. For the Concept Plan requirements, complete sections I, II & III of this form as much as possible. Submit 2 full size 24 x 36 plans and seven 11 x 17 reductions. Submit check for review fee per HOA schedule at time of submittal. B. SCHEMATIC PLAN REVIEW 1. The intent of the Schematic Plan Review is to allow the applicant and owner the ability to present schematic site plan, floor plans and elevations for review and compliance with the Design Guidelines. 2. For the Schematic Plan requirements, complete sections I, II & III of this form as much as possible. Submit 2 full size 24 x 36 plans and seven 11 x 17 reductions. Submit check for review fee per HOA schedule at time of submittal. C. DESIGN PLAN REVIEW 1. For Design Plan requirements, refer to Appendix B - Design Plan Review Procedures and Appendix E Design Review Plan Summary Checklist in the 3 Creek Ranch Design Guidelines and Regulations. 2 Submit completed Application, Sections I, III, IV and V. 3. Submit check for review fee per HOA schedule at time of submittal. D. CONSTRUCTION PLAN REVIEW 1. For details of the Construction Plan Review submission requirements, refer to Appendix B Construction Plan Review Procedures and Appendix E Construction Plan Review Summary Checklist. 2 Submit completed Application Form, Sections I, III, IV and V. Submit check for review fee per HOA schedule at time of submittal. 3 of 10 pages

4 E. REVISIONS TO APPROVED PLANS OR HOMES 1. Describe item(s) to be modified: 2. Plan Requirements: a. Submit photos or previously approved plans. b. Submit modified elevations, floor plan and/or site plan as appropriate. 3. Submit completed Applications, Sections I, III, IV and V as appropriate. F. MISCELLANEOUS PROJECT REVIEW PROCESS 1. Submit two full size 24 x 36 plans and seven 11 x 17 reduced plans. 2. Submit completed Application Form, Sections I, II, III, IV and/or V as appropriate. 3. Submit check for review fee at time of submittal. 4 of 10 pages

5 Section III Project data Name of Project: Location: Lot Check one: Single Family Primary Secondary A. Number of Dwelling Units: Number of Other Building Units B. Total Lot Acreage: C. Maximum Allowable Building Height: D. Proposed Maximum Gross Floor Area: Primary Unit sq. ft. Secondary Unit sq. ft. Other Habitable Unit (s) sq. ft Total sq. ft. Garages sq. ft Area of second floor and % of first floor. E. Number of Bedrooms, All Units F. Number of Covered Parking Spaces Number of Uncovered Parking Spaces Total Parking G. Number of Kitchens Number of Bathrooms Number of Fireplaces a) Gas: b) Wood burning c) Outdoor Fireplace (Required to have a chimney & spark arrestor. No open fire pits are allowed). H. Building Height Calculation: feet. (Submit drawing of building height calculations drawn over building elevations). I. Area of Allowable Impervious Surface used Total allowed 5 of 10 pages

6 Section IV List of Materials Name of Project: Location: Lot The following information must be submitted by the Applicant to the ARC prior to attending the meeting and should be presented at the ARC meeting. Color chips, siding and stone samples, etc. Building Materials: Type of Material Specification, Product Color, Material, etc. Roof (Pitch is ) Primary Wall Material Fascia Soffits Windows Window Trim Exterior Doors Garage Doors Door Trim Hand or Deck Rails Flues, Caps Flashings Chimney Enclosures Trash Enclosures (locate on plans) Gutters Screening for AC units Other Improvement(s) * Please indicate location of utility meters, AC units and exterior light fixtures on plans. Attach cutsheets for exterior light fixtures indicating bulb type and fixture and glazing materials. ** Please note that a full-scale mock-up of all exterior materials with proposed colors is required during the construction phase prior to installation for final ARC approval. Please refer to Appendix F of the 3 Creek Ranch Design Guidelines. 6 of 10 pages

7 Section V Landscape Plan Name of Project: Location: Lot Refer to the Plant Material size and mix requirements for each lot type in the 3 Creek Ranch Design Guidelines. Plant Material Botanical Name Common Name Quantity Size Proposed trees Existing trees to be removed Proposed shrubs Ground cover Sod Seed 7 of 10 pages

8 Section V Landscape Plan Continued Types of edging Type of irrigation Type or method of erosion control OTHER LANDSCAPE FEATURES (retaining walls, fences) Please specify height, materials and colors, if applicable. These walls must be identified on the plans. PAVING MATERIALS (driveways, walkways, patios, etc.) All areas that cars drive or park on are considered impervious per Teton County. ADDRESS MARKER Description (submit details and/or cut-sheets if applicable) SITE LIGHTING Description (note lighting locations on plan and submit cut-sheets) MISCELLANEOUS hot tubs, play structures, sculptures or any other structure on the lot needs to be submitted for review and approval. 8 of 10 pages

9 Section VI Letter of Authorization The following Letter of Authorization needs to be signed and dated by the Owner of the property identifying the Agent hired who is authorized to make applications on their behalf. LETTER OF AUTHORIZATION, Owner whose address is:, as owner of property more specifically described as: HEREBY AUTHORIZES as agent to represent and act for the Owner in making applications for and receiving and accepting on the Owners behalf, of any approvals or other action by the 3 Creek ARC or 3 Creek HOA, relating to the planning, design or improvements of the above noted property. Owner agrees that Owner is or shall be deemed conclusively to be fully aware of and to have authorized and/or made any and all representations or promises contained in said application of any Owner information in support thereof, and shall be deemed to be aware of and to have authorized any subsequent revisions, corrections or modifications to such materials. Owner acknowledges and agrees that Owner shall be bound and shall abide by the written terms or conditions of issuance of any such named representative, whether actually delivered to Owner of not. Owner agrees that no construction or modification, improvement, change to a structure or land involved in the application shall take place until approved by the 3 Creek ARC or 3 Creek HOA, in accordance with the Design Guidelines and CC&R s. Owner agrees to pay any fines and be liable for any other penalties arising out of the failure to comply with the terms of any approval or arising out of any violation of the Design Guidelines and CC&R s. Under penalty of perjury, the undersigned swears that the foregoing is true and, if signing on behalf of a corporation, partnership, limited liability company or other entity, the undersigned swears that this authorization is given with the appropriate approval of such entity, if required. OWNER: (Signature of Owner) (Signature of Co-Owner) Title: (Secretary or Corporate Owner) STATE OF SS. COUNTY OF Subscribed and sworn to before me by this day of, 20. WITNESS my hand and official seal. Notary Public My commission expires: 9 of 10 pages

10 Section VII Letter of View Corridor Notification and Maintenance Requirement, Owner whose address is:, as owner of property more specifically described as: HEREBY ACKNOWLEDGES that they are fully aware of the documented View Corridor as described on the MAP held by the 3 Creek ARC and HOA. That all current and future plantings within the View Corridor, will be maintained to meet the requirements and specifications of the MAP and the Design Guidelines. Owner agrees that no modification, improvements, or changes to the landscaping involved in the View Corridor shall take place until approved by the 3 Creek ARC or 3 Creek HOA, in accordance with the Design Guidelines and CC&R s. Said approved modifications, improvements, or changes to the landscaping are required to be inspected for compliance to the Design Guidelines and requirements of the MAP after installation. Owner agrees to pay any fines and be liable for any other penalties arising out of the failure to comply with the terms of any approval or arising out of any violation of the Design Guidelines and CC&R s. Under penalty of perjury, the undersigned swears that the foregoing is true and, if signing on behalf of a corporation, partnership, limited liability company or other entity, the undersigned swears that this authorization is given with the appropriate approval of such entity, if required. OWNER: (Signature of Owner) (Signature of Co-Owner) Title: (Secretary or Corporate Owner) STATE OF SS. COUNTY OF Subscribed and sworn to before me by this day of, 20. WITNESS my hand and official seal. Notary Public 10 of 10 pages

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